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Slow Growth, Downward Revisions in Health Jobs Continue

blsFor the second month in a row, the Employment Situation Summary showed a slowing down in the growth of jobs in health services versus non-health jobs, relative to recent history. Further, revisions to data in this morning’s very strong jobs report indicate high job growth reported in health services for December and January were not correct.

Health jobs increased only 0.17 percent in this morning’s jobs report, versus 0.16 percent for non-health jobs. With 27,000 jobs added, health services accounted for 11 percent of new nonfarm civilian jobs.

This continues a welcome development. The previous disproportionately high share of job growth in health services was a deliberate outcome of Obamacare. If this trend persists, it will become increasingly hard to carry out reforms that will improve productivity in the delivery of care.

Ambulatory sites added jobs at a much faster rate than hospitals (0.25 percent versus 0.12 percent). This was concentrated in physicians’ offices and home health. This is a good sign because these are low-cost locations of care.

See Table I below the fold:

Obamacare’s Perverse Job Creation Program

doctor-with-familyThe latest jobs report gave the stock market a boost and injected some optimism into public sentiment about our economic prospects. Unfortunately there’s a problem with the current employment situation that few understand: Obamacare has likely led to too many jobs in health care, drawing labor from more productive functions.

Dan Diamond of Politico reports jobs in health care have grown 23 percent since 2005, while jobs overall have grown only 6 percent. Much of this was driven by the collapse of non-health jobs in 2008-2010, while health jobs remained undisturbed. As the economy recovered, Obamacare kept layering jobs onto health care that did not actually improve health care:

Huge Health Jobs Hike, Especially in Hospitals

BLSThis morning‘s tepid jobs report (Employment Situation Summary) was dominated by health services, which added 37,000 jobs in January. That is just one percentage point shy of one quarter of all nonfarm civilian jobs added (Table I).

Within health care, hospitals dominated, accounting for 24,000 of the 37,000 increase – almost two thirds. (This is interesting because there has been a slowdown in health construction starts. So, there must be a lot of slack in already built facilities.) Hospitals are generally inefficient locations of care, so the pickup in employment in January is actually of concern because it likely indicates more expensive care.

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Health Jobs Pick Up in Booming Jobs Report

BLSToday’s Employment Situation Summary, which came in above strong expectations, also saw faster growth in health services jobs than other nonfarm civilian jobs. In December, health services jobs grew at 0.26 percent, versus only 0.20 percent for other jobs. Health services jobs comprised 13 percent of the 292,000 jobs added in December (Table I).

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Within health services, outpatient care jobs grew much faster than jobs at other facilities. Overall, jobs at ambulatory facilities grew faster than hospital jobs. This is a good development because hospitals are less efficient locations of care.

Hospitals Dominate Health Jobs In November

BLSThe November Employment Situation Summary came in as expected, with 211,000 nonfarm civilian jobs added. Last month’s report was dominated by health jobs, which was not the case today. The increase of 24,000 health jobs comprised only 11 percent of the payroll hike, and both health and non-health jobs rose by 15 percent on the month (Table I).

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However, hospital jobs, which increased 13,000, comprised over half the growth in health jobs. This is something we view with concern. We prefer to see health jobs grow in ambulatory settings, because hospitals are the most expensive location of care. Hopefully, technology will move more health services out of the hospitals.

Health Jobs Dominate Great Jobs Report

BLSObservers cheered the October Employment Situation Summary, which reported 271,000 civilian nonfarm jobs added. This is a big turnaround from the September report, which was very disappointing. Nevertheless, the two months have one thing in common: Jobs in health services dominated the growth in jobs. Whether job growth overall is strong or weak, health care keeps increasing its share.

Health care accounted for 45,000 of the 217,000 jobs added overall in October (Table I). That’s a rate of growth of 0.29 percent, much higher than 0.18 percent growth in non-health jobs. Jobs in ambulatory facilities accounted for 27,000 of the increase, which hospital jobs only increased by 18,000. Ambulatory jobs now account for a significantly higher share of health jobs than hospitals do. This change is positive, because hospitals are inefficient and overly expensive facilities for many procedures.

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Health Jobs Dominate Terrible Jobs Report

No good words were used to describe last week’s Employment Situation Summary: “Every aspect of the September jobs report was disappointing,” wrote Michelle Girard, chief U.S. economist at RBS (quoted in Forbes). This is largely a repeat of the August jobs report, although those and previous months’ figures were also revised downwards.

One quarter of September’s new jobs were in health services: 34,000 of 142,000 added to nonfarm payrolls (see Table II). Of those 34,000 health jobs, 37 percent were in ambulatory facilities, and 45 percent in hospitals. This is a change from the last few months. Because of a long-term shift in the location of care, there are now almost seven million people working in ambulatory settings, versus just under five million working in hospitals.

Hospital Margins Up 9 Percent

This morning’s Quarterly Services Survey (QSS), published by the Census Bureau, reported that:

The estimate of U.S. health care and social assistance revenue for the second quarter of 2015, not adjusted for seasonal variation, or price changes, was $591.3 billion, an increase of 2.2 percent (± 0.8%) from the first quarter of 2015 and up 6.4 percent (± 1.3%) from the second quarter of 2014. The fourth quarter of 2014 to first quarter of 2015 percent change was revised from -0.4 percent (± 1.1%) to -0.5 percent (± 1.1%).

The QSS adds important information to the more widely reported quarterly Gross Domestic Product (GDP) and Employment Situation Summary (ESS) releases that I frequently discuss on the blog.

Health Care One Quarter of August Job Growth

This morning’s Employment Situation Summary, which showed slow job growth overall, contained a big jump for health services: 23 percent of last month’s jobs were in health services (see Table I).

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Of the 41,000 health jobs, a little more than half were in ambulatory settings. Because of a long-term shift in the location of care, there are now almost seven million people working in ambulatory settings, versus just under five million working in hospitals. This is a positive development.

Hospital Job Growth Up Vs. Other Health Jobs

The July Employment Situation Summary from the Bureau of Labor Statistics showed health services jobs growing at about the same pace as other jobs: 0.18 percent growth versus 0.15 percent growth. This is a break from most previous months, when health services job growth outpaced other nonfarm civilian jobs significantly. 28,000 of the 215,000 jobs added in July were in health services.

However, there was a significant uptick in the rate of jobs growth in hospitals: Adding 16,000 jobs, hospital employment counted for significantly more than half of health services jobs growth (see Table I).

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Jobs growth in nursing care facilities continued to stagnate, where employment in has been flat for twelve months (See Table II).